Bades and medicines: compatibility and risks

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Bades and medicines: compatibility and risks

I. Introduction to the world of dietary supplements and drugs: various categories and goals

To understand the complexity of the interaction between dietary supplements (biologically active additives) and drugs, it is necessary to clearly distinguish between these two categories of products and realize their various goals. Medicines, or pharmaceuticals, are developed, tested and regulated by strict rules for the treatment, relief, preventing or diagnosing diseases. They undergo long clinical trials to prove their effectiveness and safety, and are prescribed by doctors for specific medical conditions.

Bades, on the other hand, are not intended for the treatment, prevention or diagnosis of any diseases. They are classified as food or food supplements and usually contain vitamins, minerals, herbs, amino acids, enzymes and other substances that are claimed to improve the general state of health and well -being. Unlike drugs, dietary supplements are not subject to such strict control by regulatory authorities, and manufacturers are not required to prove their effectiveness or safety before the market.

This fundamental difference in regulation and goals has significant consequences for potential interactions between dietary supplements and medicines. Since dietary supplements do not undergo the same thorough checks as medicines, information about their composition, efficiency and safety can be incomplete or inaccurate. This makes it difficult to predict how they can interact with medicines and what risks can be associated with their simultaneous intake.

II. Mechanisms of interaction between dietary supplements and drugs: pharmacokinetic and pharmacodynamic aspects

The interaction between dietary supplements and drugs can occur according to various mechanisms affecting the pharmacokinetics and pharmacodynamics of the drug. Pharmacokinetics describes what the body does with the medicine, including absorption, distribution, metabolism and excretion (adme). Pharmacodynamics, on the other hand, describes what the medicine does with the body, including its mechanism of action and the therapeutic effect.

A. Pharmacokinetic interactions:

  1. Impact of absorption: Some dietary supplements can affect the absorption of drugs in the gastrointestinal tract. For example, the dietary fiber contained in some additives can be associated with medicines, preventing them from absorption in the blood. Antacids, which are sometimes taken to facilitate heartburn, can change the stomach pH, ​​which can affect the solubility and absorption of some drugs. Helated compounds formed by some minerals (for example, calcium, iron, magnesium) can be associated with certain drugs such as tetracycline antibiotics and bisphosphonates, reducing their absorption.

  2. Influence on metabolism: The metabolism of drugs occurs mainly in the liver, where the enzymes of cytochrome P450 (CYP) play a key role in the breakdown and inactivation of drugs. Some dietary supplements can induce or inhibit these enzymes, affecting the rate of drug metabolism. For example, St. John’s wort (Hypericum Perforatum) is a famous inducer of CYP3A4, an enzyme that metabolizes many drugs, including antidepressants, contraceptive tablets and immunostressants. CyP3A4 induction can lead to a decrease in the concentration of these drugs in the blood and a decrease in their effectiveness. On the other hand, some dietary supplements, such as grapefruit juice, can inhibit CYP3A4, increasing the concentration of drugs in the blood and increasing the risk of side effects.

  3. Influence on excretion: Some dietary supplements can affect the excretion of medicines from the body through the kidneys or liver. For example, some diuretics contained in herbal additives can increase the excretion of drugs through the kidneys, reducing their concentration in the blood. Some dietary supplements can affect the activity of transporters involved in the removal of medicines through the liver, which can also affect their concentration in the blood.

  4. Influence on the distribution: Some dietary supplements can affect the distribution of drugs in the body, changing the binding of drugs with plasma proteins. If the medicine is greatly associated with plasma proteins, then only the unrelated form of the drug is pharmacologically active. If the dietary supplement competes with the medicine for connecting with plasma proteins, this can increase the concentration of the free, active form of the drug, which can lead to increased effects or side effects.

B. Pharmacodynamic interactions:

Pharmacodynamic interactions occur when dietary supplements and medicine affect the body in a similar or opposite way.

  1. Synergism: Synergism occurs when dietary supplements and medicine enhance each other’s effect. For example, taking a dietary supplement with anticoagulant properties, such as ginkgo bilobe, along with an anticoagulant, such as warfarin, can increase the risk of bleeding.

  2. Antagonism: Antagonism occurs when dietary supplements and medicine reduce each other’s effect. For example, the intake of a dietary supplement containing vitamin K can reduce the effectiveness of the anticoagulant of warfarin, since vitamin K is involved in blood coagulation.

  3. Additative effect: The additive effect occurs when dietary supplements and medicine have a similar effect on the body. For example, taking a dietary supplement reducing blood pressure, along with a medicine that reduces blood pressure, can lead to an excessive decrease in blood pressure (hypotension).

III. Specific examples of interactions of dietary supplements and medicines:

Consider specific examples of interactions in order to illustrate potential risks and consequences of the simultaneous administration of dietary supplements and drugs.

  1. Varfarin and vitamin K: Warfarin is an anticoagulant that is used to prevent blood clots. Vitamin K, on ​​the other hand, plays an important role in blood coagulation. The intake of vitamin K can reduce the effectiveness of warfarin, which can increase the risk of blood clots. Therefore, patients taking warfarin need to maintain a constant level of vitamin K consumption and avoid sharp changes in their diet or intake of dietary supplements containing vitamin K.

  2. Digoxin and St. John’s wort: Digoxin is a medicine that is used to treat heart failure and irregular heartbeat. St. John’s wort is a herbal additive that is used to treat depression. St. John’s wort is an inducer of CYP3A4, an enzyme that metabolizes digoxin. The intake of St. John’s wort can reduce the concentration of digoxin in the blood, which can reduce the effectiveness of digoxin and lead to a deterioration in the symptoms of heart failure or irregular heartbeat.

  3. Mao and Tiramin inhibitors: Monoaminoxidase inhibitors (MAO) are a class of antidepressants. Tiramin is an amino acid that is contained in some foods, such as excited cheese, jerky meat and fermented products. MAO inhibitors block the breakdown of tyramine in the body. Reception of Mao inhibitors, together with products rich in Tramin, can lead to a dangerous increase in blood pressure (hypertensive crisis).

  4. Antidiabetic drugs and chrome: Chrome is a mineral that is believed to improve blood sugar. Taking chromium along with antidiabetic drugs can enhance their effect, which can lead to hypoglycemia (low blood sugar). Patients with diabetes taking chrome need to carefully monitor the blood sugar level and adjust the dose of their antidiabetic drugs as necessary.

  5. Statins and red yeast rice: Statins are a class of drugs that are used to reduce cholesterol. Red yeast rice is a food supplement that contains Monacoline K, which is chemically identical to lovastatin, statin released according to the recipe. The intake of red yeast rice along with statins can increase the risk of side effects, such as muscle damage (myopathy) and liver damage.

  6. Immunodepressants and echinacea: Immunosuppressants are drugs that are used to suppress the immune system, for example, after organs transplantation. Echinacea is a herbal additive, which is believed to stimulates the immune system. Reception of echinacea, along with immunosuppressants, can reduce their effectiveness, which can increase the risk of rejection of the graft.

  7. Anticoagulants and garlic: Garlic has anticoagulant properties and can enhance the effect of anticoagulants such as warfarin or aspirin, increasing the risk of bleeding. Patients taking anticoagulants should be used with caution in large quantities or take additives with garlic.

  8. Broadcasting tablets and St. John’s wort: St. John’s wort is an inducer of CYP enzymes that participate in the metabolism of many drugs, including contraceptive tablets. Reception of St. John’s wort can reduce the effectiveness of contraceptives, increasing the risk of unwanted pregnancy.

  9. Preparations for blood pressure and coenzyme Q10: Coenzyme Q10 (COQ10) is sometimes used to support the health of the heart and can have a small hypotensive effect. Reception of COQ10, together with drugs from blood pressure, can lead to an excessive decrease in blood pressure, especially at the beginning of treatment.

  10. Antidepressants (SIOS) and St. John’s wort: As already mentioned, St. John’s wort can interact with antidepressants, especially with selective inhibitors of the reverse capture of serotonin (SIOS). Simultaneous intake can lead to serotonin syndrome, serious condition, characterized by anxiety, excitement, tremor, increased sweating and other symptoms.

IV. Risk groups: who is at the highest risk of interactions of dietary supplements and medicines?

Some groups of people are more at risk of developing interactions between dietary supplements and medicines.

  1. Elderly people: Elderly people often take several drugs at the same time (polypharmation), which increases the risk of interactions. In addition, with age, the function of the liver and kidneys can decrease, which can affect metabolism and excretion of medicines and dietary supplements, increasing the risk of interactions.

  2. People with chronic diseases: People with chronic diseases, such as heart disease, diabetes, liver and kidney diseases, often take several drugs and are more prone to the use of dietary supplements to facilitate symptoms or improve their health. This increases the risk of interactions.

  3. People taking several drugs (polyfarmation): The more drugs a person takes, the higher the risk of interaction between medicines and dietary supplements.

  4. People who are self -speaking dietary supplements: People who independently accept dietary supplements without consulting a doctor or pharmacist may not know about potential interactions between dietary supplements and medicines that they take.

  5. Pregnant and lactating women: Pregnant and lactating women should be especially careful when taking dietary supplements, since some dietary supplements can be harmful to the developing fruit or child. In addition, the interaction of dietary supplements with drugs used during pregnancy may have serious consequences.

  6. Children: Children should give dietary supplements only under the supervision of a doctor. The metabolism of drugs in children differs from metabolism in adults, and the interaction of dietary supplements with drugs can be more unpredictable.

V. How to minimize the risks of interactions of dietary supplements and drugs: recommendations for patients and health specialists

In order to minimize the risks of the interactions of dietary supplements and drugs, it is important to comply with several recommendations for both patients and health specialists.

A. Recommendations for patients:

  1. Tell your doctor about all the medicines and dietary supplements that you take: It is important to inform your doctor about all drugs (both on the prescription and without a prescription) and dietary supplements that you accept, including the dosage and frequency of admission. This will allow your doctor to evaluate the risk of interactions and give appropriate recommendations.

  2. Do not start taking new dietary supplements without consulting a doctor or pharmacist: Before you start taking a new dietary supplement, consult your doctor or pharmacist to make sure that he is safe for you and does not interact with the medicines that you are taking.

  3. Read the labels of dietary supplements and medicines: Carefully read the labels of dietary supplements and medicines to learn about potential interactions and side effects.

  4. Buy dietary supplements from reliable manufacturers: Buy dietary supplements from reliable manufacturers who adhere to quality standards and provide accurate information about their products. Look for products that have passed testing a third party to make sure their quality and cleanliness.

  5. Follow your condition and report any side effects: If you notice any unusual or unexpected side effects after taking a dietary supplement or medicine, immediately inform your doctor about it.

  6. Do not assume that “natural” means “safe”: Just because dietary supplements are “natural”, this does not mean that it is safe for everyone. Some natural substances can interact with drugs or have side effects.

  7. Be especially careful if you are risk: If you belong to the risk group, such as elderly people, people with chronic diseases or pregnant or nursing women, you should be especially careful when taking dietary supplements.

B. Recommendations for health specialists:

  1. Ask patients about all the medicines and dietary supplements that they take: When collecting an anamnesis in patients, it is important to ask them about all drugs (both in the prescription and without a prescription) and dietary supplements that they accept.

  2. Be in the know of potential interactions of dietary supplements and medicines: Health specialists should be aware of potential interactions of dietary supplements and drugs and take them into account when prescribing drugs.

  3. Use resources to check interactions: There are various resources, such as databases and programs that can help health care specialists check potential interactions between medicines and dietary supplements.

  4. Explain to patients the risks and advantages of using dietary supplements: Health specialists should explain to patients the risks and advantages of using dietary supplements and give them reasonable recommendations.

  5. Report adverse events related to dietary supplements: Health specialists must report any adverse events related to dietary supplements to the relevant authorities.

  6. Consider the individual factors of the patient: When assessing the risk of interactions of dietary supplements and drugs, it is necessary to take into account the individual factors of the patient, such as age, health, liver and kidney function.

  7. Encourage open dialogue with patients: It is important to create an atmosphere of an open dialogue so that patients feel comfortable, discussing their medicines and the use of dietary supplements with their doctors.

VI. Legal regulation of dietary supplements: comparison of various countries

The legal regulation of dietary supplements is significantly different in different countries, which may complicate the assessment of their safety and efficiency. In some countries, such as the United States, dietary supplements are regulated as food, and not as medicines, which means that they are not subject to the same strict test and approval as medicines. In other countries, such as Germany and Canada, dietary supplements are regulated more strictly and require evidence of safety and efficiency before the market.

A. USA: In the United States, dietary supplements are regulated by the Law on Food Addles, Health and Education (DSHEA) of 1994. This law defines dietary supplements as food and does not require manufacturers to prove the safety or effectiveness of their products before launching on the market. However, manufacturers are responsible for ensuring the safety of their products and must report well -known side effects in the management of products and medicines (FDA). FDA can take measures against dietary supplements that are recognized as unsafe or contain false information.

B. European Union (EU): In the EU, dietary supplements are regulated by the Directive 2002/46/EC on food additives. This directive establishes harmonized rules for vitamins and minerals used in dietary supplements and requires manufacturers to provide information about the safety and efficiency of their products. However, the regulation of other ingredients used in dietary supplements, such as grass, remains mainly in the competence of individual EU member states.

C. Canada: In Canada, dietary supplements are regulated by the rules on natural medical products (NHPR). These rules require that manufacturers receive a license to sell their products and provide evidence of safety and efficiency. The Ministry of Health of Canada evaluates evidence and can issue licenses for products that are considered safe and effective.

D. Australia: In Australia, dietary supplements are regulated by the management of therapeutic goods (TGA). TGA requires manufacturers to record their products and provide evidence of safety and efficiency. TGA also monitors side effects and can take measures against products that are recognized as unsafe or contain false information.

E. Other countries: The regulation of dietary supplements is significantly different in other countries. In some countries, such as China and India, there are traditional systems of medicine that include the use of herbs and other natural substances. The regulation of these products can be difficult and vary depending on the specific system of medicine.

Differences in the regulation of dietary supplements between countries can make it difficult to assess their safety and efficiency. It is important for patients to be careful when buying dietary supplements abroad or via the Internet and make sure that they buy products from reliable manufacturers who adhere to quality standards.

VII. Future research areas: the need for further research of dietary supplements and drugs

Further research is needed for a better understanding of interactions between dietary supplements and medicines. Many dietary supplements were not carefully studied, and there is often not enough information about their safety and efficiency. In addition, there are few studies devoted to interactions between dietary supplements and medicines, especially in relation to chronic diseases and polypharmation.

Future research should be focused on the following areas:

  1. Safety and efficiency assessment: It is necessary to conduct more research to assess the safety and efficiency of dietary supplements, especially in relation to long -term use and in combination with medicines.

  2. Studying the mechanisms of interactions of dietary supplements and drugs: It is necessary to conduct more studies to study the mechanisms of interactions of dietary supplements and drugs, including pharmacokinetic and pharmacodynamic interactions.

  3. Identification of risk groups: It is necessary to conduct more studies to identify risk groups at risk of dietary supplements and drugs.

  4. Development of strategies to minimize risks: It is necessary to develop strategies to minimize the risks of interactions of dietary supplements and drugs, including educational programs for patients and health specialists.

  5. Badov Standardization: It is necessary to standardize dietary supplements in order to ensure their quality, cleanliness and compliance with labels.

  6. Improving the regulation of dietary supplements: It is necessary to improve the regulation of dietary supplements in order to ensure their safety and efficiency.

Conducting these studies will help to better understand the interaction between dietary supplements and drugs and develop strategies to minimize risks and ensure patient safety. This requires cooperation between researchers, health specialists, regulatory bodies and dietary supplements.

VIII. The role of health specialists: advising patients on the use of dietary supplements

Health specialists play an important role in advising patients on the use of dietary supplements. They should be aware of potential interactions of dietary supplements and drugs and give patients reasonable recommendations.

Health specialists should:

  1. Ask patients about all medicines and dietary supplements that they take: This allows you to evaluate the risk of interactions and give appropriate recommendations.

  2. Assess the risks and advantages of using dietary supplements: Health specialists must evaluate the risks and advantages of using dietary supplements, taking into account the individual factors of the patient, such as age, health and medicine.

  3. Provide patients with information about dietary supplements based on facts: It is important to provide patients with information about dietary supplements based on facts, including their potential advantages, risks and interactions with drugs.

  4. Help patients make reasonable decisions: Health specialists must help patients make reasonable decisions on the use of dietary supplements, taking into account their individual needs and goals.

  5. Encourage open dialogue: It is important to create an atmosphere of an open dialogue so that patients feel comfortable, discussing their medicines and the use of dietary supplements with their doctors.

  6. Monitor patients for side effects: Health specialists must monitor patients for side effects of dietary supplements and report any adverse events.

  7. Improve your qualifications: Health experts must constantly improve their qualifications in the field of the use of dietary supplements and drug interactions in order to provide patients with the best possible assistance.

The role of health care specialists in advising patients on the use of dietary supplements is crucial for ensuring patient safety and optimizing their health. This requires knowledge, skills and ability to communicate, as well as commitment to the principles of evidence -based medicine.

IX. Practical tips for consumers of dietary supplements:

Here are a few practical tips for consumers considering the possibility of using dietary supplements:

  1. First of all, talk to your doctor: This is perhaps the most important advice. Your doctor knows your medical history and can give you individual recommendations about whether dietary supplements are suitable for you and what risks can be associated with their intake, given your existing medicines and conditions.

  2. Define your goals: What do you hope to achieve with the help of dietary supplements? Improve the overall health of your health? Eliminate a specific deficit? Support a certain function of the body? A clear understanding of your goals will help you choose the right additives and more effectively discuss them with your doctor.

  3. Learn the information: Conduct your own study about the dietary supplements that you are considering. Use reliable sources such as websites of national healthcare institutions (NIH), FDA and other organizations that provide scientifically sound information.

  4. Be skeptical about the statements: If the statements of health benefits seem too good to be true, most likely it is. Beware of products that promise wonderful healing or quick results.

  5. Pay attention to the ingredients and dosage: Read the label carefully and make sure that you understand what is part of the dietary supplement and in what quantity. Make sure that the dosage corresponds to your needs and that you do not exceed the recommended dose.

  6. Choose quality products: Buy dietary supplements from reliable manufacturers who adhere to quality standards. Look for products that have been tested by a third party to make sure of their cleanliness and fit the label. Some organizations, such as NSF International, USP and Consumerlab.com, test dietary supplements and certify those that meet their standards.

  7. Be attentive to interactions: Consider the potential interactions of dietary supplements with the medicines that you take, as well as with other dietary supplements. Tell your doctor about all the products that you use so that he can evaluate the risk of interactions.

  8. Start small: If you begin to take a new dietary supplement, start with a low dose and gradually increase it as necessary. This will allow you to evaluate your tolerance and reduce the risk of side effects.

  9. Follow your condition: Pay attention to any changes in your health or well -being after the start of the Bad. If you notice any unusual or alarming symptoms, stop taking the product and consult a doctor.

  10. Do not replace medicines with dietary supplements: Bades are not intended for replacing drugs prescribed by a doctor. Do not stop taking medications and do not change the dosage without consulting a doctor.

  11. Keep the dietary supplement correctly: Keep dietary supplements in accordance with the instructions on the label. Most dietary supplements should be stored in a cool, dry place, away from direct sunlight and moisture.

  12. Be careful when buying online: When buying dietary supplements online, be especially careful, as there is a risk of buying fake or low -quality products. Buy only from reliable online seller.

Compliance with these practical tips will help you make a reasonable choice for the use of dietary supplements and reduce the risk of potential problems. Remember that dietary supplements are not a replacement for a healthy lifestyle, which includes a balanced diet, regular physical exercises and sufficient sleep. They can be a useful addition to a healthy lifestyle, but they should be used with caution and under the guidance of a doctor.

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